MNLP – Module 4 – Final assessment

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Question 1 of 20

1. Question
1 point(s)
Which of the following is the best single indicator of prognosis at diagnosis of myeloma?
- A. Presence of renal failure
- B. C-reactive protein concentration
- C. Serum beta 2 microglobulin concentration
- D. Bone marrow plasma cell count
- E. Bence Jones protein concentration
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Question 2 of 20

2. Question

5 point(s)

There are a number of prognostic factors in myeloma. Match the words below with their description.

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Cytogenetic factors
Plasma cell morphology
C-reactive protein
Plasma cell labelling index
Beta 2 microglobulin

Chromosomal abnormalities

Structural features of plasma cells indicate their degree of maturity

A protein produced by the liver during inflammatory or malignant processes

The relative percentage of plasma cells actively growing

A cell surface protein, the levels of which reflect the extent of the disease

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Question 3 of 20

3. Question
1 point(s)
When a patient is classified as Stage 2 according to the International Staging system, their likely median survival is
- A. 29months
- B. 56 months
- C. 83 months
- D. Not reached
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Question 4 of 20

4. Question
1 point(s)
Staging in myeloma is necessary because it
- A. Determines the extent of the disease
- B. Allows an assessment of the likely prognosis
- C. Helps make decisions about treatment
- D. All of the above
- E. None of the above
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Question 5 of 20

5. Question
1 point(s)
Which of the following is a staging system used in myeloma?
- A. International staging system
- B. The TNM classification
- C. FIGO staging system
- D. Dukes staging system
- E. Gleason scoring system
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Question 6 of 20

6. Question
1 point(s)
Which of the following is associated with a poorer prognosis
- A. Serum beta 2 microglobulin concentration of 3.0mg/l
- B. Serum albumin concentration of 25g/l
- C. Hypocalcaemia
- D. Chromosomal abnormality involving translocation t[11;14]
- E. Chromosomal abnormality involving gain of chromosome 3
Correct

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Question 7 of 20

7. Question
1 point(s)
The Durie-Salmon staging system for myeloma includes which of the following factors?
- A. Serum paraprotein and haemoglobin concentrations
- B. Serum paraprotein and serum albumin concentrations
- C. Serum albumin and number of lytic lesions
- D. Serum beta 2 microglobulin and number of lytic lesions
- E. Serum beta 2 microglobulin concentration
Correct

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Question 8 of 20

8. Question
1 point(s)
A myeloma patient presents with a haemoglobin level of 80g/l and a serum creatinine of 31mg/l. What stage are they according to the Durie-Salmon staging system?
- A. Stage I
- B. Stage IIA
- C. Stage IIB
- D. Stage IIIA
- E. Stage IIIB
Correct

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Question 9 of 20

9. Question
1 point(s)
Which of the following is associated with improved prognosis?
- A. Chromosomal abnormality involving deletion of chromosome 13
- B. Serum albumin concentration of 30g/L
- C. Normal lactate dehydrogenase levels
- D. Predominance of plasmablasts on bone marrow examination
- E. Beta 2 microglobulin concentration of 7.0mg/L
Correct

Incorrect
Question 10 of 20

10. Question
1 point(s)
The Intermational staging system for myeloma uses which of the following factors
- A. Serum paraprotein concentration
- B. Serum free light chain concentration
- C. Haemoglobin concentration
- D. Serum albumin concentration
- E. Serum creatinine concentration
Correct

Incorrect
Question 11 of 20

11. Question
1 point(s)
Which of the following tests is the best single indicator of tumour burden in myeloma?
- A. Serum beta 2 microglobulin
- B. C-reactive protein
- C. Blood urea nitrogen
- D. Serum lactate dehydrogenase
- E. Serum creatinine
Correct

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Question 12 of 20

12. Question
1 point(s)
Patients with the following chromosomal abnormalities are defined as “high-risk” except
- A. Chromosomal abnormality involving translocation t[4;14]
- B. Chromosomal abnormality involving translocation t[11;14]
- C. Chromosomal abnormality involving translocation t[14;16]
- D. Chromosomal abnormality involving deletion of chromosome 17
- E. Chromosomal abnormality involving deletion of chromosome 13
Correct

Incorrect
Question 13 of 20

13. Question
1 point(s)
Which of the following imaging techniques provides the most useful prognostic information?
- A. Radiological skeletal survey
- B. Computed tomography (CT)
- C. Magnetic resonance imaging (MRI)
- D. Positron emission tomography (PET)
- E. Combined positron emission tomography/ computed tomography (PET/CT)
Correct

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Question 14 of 20

14. Question
1 point(s)
Assertion: It is important that patients are accurately staged when entering clinical trials

BECAUSE

Reason: Response to treatment is one of the most important factors that predicts long-term outcome
- A. True True Reason correctly explains assertion
- B. True True Both statements are true but the reason does not explain assertion
- C. True False
- D. False True
- E. False False
Correct

Incorrect
Question 15 of 20

15. Question
1 point(s)
Assertion: Measurement of minimal residual disease (MRD) is a new concept that is considered to have powerful prognostic significance

BECAUSE

Reason: Patients who are MRD positive are likely to relapse more quickly
- A. True True Reason correctly explains assertion
- B. True True Both statements are true but the reason does not explain assertion
- C. True False
- D. False True
- E. False False
Correct

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Question 16 of 20

16. Question

1 point(s)

Match the terms with the definition.

Sort elements

High risk
Low risk
Standard risk

Patients who are ISS stage II/III and have translocation t[4;14] or deletion [17p]

Patients who are ISS stage I/II, under the age of 55 and who do not have translocation t[4;14] or deletion [17p]

Patients who are ISS stage II/III and do not have translocation t[4;14] or deletion [17p]

Correct

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Question 17 of 20

17. Question
1 point(s)
The staging system in myeloma reflects the extent of the disease rather than where it is
- A. True
- B. False
Correct

Incorrect
Question 18 of 20

18. Question
1 point(s)
Which of the following statements is not true
- A. Prognostic factors include a number of clinical and laboratory findings
- B. Prognostic factors include age, comorbidities and performance status
- C. Prognostic factors can accurately determine patient outcomes
- D. Staging of myeloma helps to determine disease activity and burden
- E. Staging of myeloma can help assess patient prognosis
Correct

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Question 19 of 20

19. Question
3 point(s)
Fill in the words two, three and four to complete the following
- According to the Durie-Salmon System, there are stages of myeloma based on the presence of main clinical features that reflect the amount and activity of the myeloma. There are three stages in the International Staging System based on the measurement of specific factors.
Correct

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Question 20 of 20

20. Question
1 point(s)
Measurement of minimal residual disease by flow cytometry is routinely carried out to determine response to treatment.
- A. True
- B. False
Correct

Incorrect

MNLP – Module 4 – Final assessment